Investigation On TCM Syndrome And Quality Of Life Among Acquired Immunodeficiency Syndrome

Research background:Syndrome differentiation and treatment is the basicPrinciple of Chinese traditional treatment. Syndrome differentiation is the basis of Chinese medicine. It can reveal the nature. location, cause and pathogenesis of disease andProvide evidence to treatment. AIDS is a emerging disease, it has complex clinical symptoms. The basic theories of Chinese medicine and clinical research of AIDS are still in the initial stage. At thePresent time, syndrome research are mostly clinical reports in which the collection of clinical information are not complete and quantitative guide and authoritative standard are not available. So the comprehensive system of Syndrome differentiation and treatment of AIDS is not completed yet. Syndrome differentiation and treatment is the basis of clinical research and drug research. It is practical and urgent to study the Syndrome differentiation and evolvement rule of AIDS under the guidance of TCM holism concept and syndrome differentiation. using modern epidemiology and EBM and modern biological detecting techniques. Considering region, Pathway of infection, course of disease, complications and laboratory index.There are still no drugs to get rid of HIV virus completely as yet. So the virus will last long in thePatients body and damage the immune system. The occurrence of opportunistic infections and cancers expanded greatly. The side-effect of anti-HIV drugs can also bring damage toPatients physical functions or even worse, their career and life. AIDS terminal patients can not take care of themselves. So researchers andPolicy makers will face the severeProblem on how to improve the quality of live(QOL) of AIDS/HIVPatients before the appearance of drugs to get rid of HIV virus completelyTCM syndrome differentiation and QOL and the relationship between the two factors of AIDS/HIV patients are investigated by the AIDS TCM syndrome differentiation questionnaire and DSQL.Objectives:1.To explicit the regular TCM syndrome differentiation of AIDS and distributing rules. To form the normalized diagnostic standards and to supply the diagnosis and treatment of AIDS with objective basis.2. To explore the relation between the major TCM syndrome differentiation and immune function. To provide basis for clinical treatment.3. To comprehend the current situation of AIDS patients. To analyze the relation between effect factors and QOL by statistical methods.4. To definite the relation between TCM syndrome differentiation and QOL, toProvide basis judging the curative effect by using TCM syndrome and QOL.Methods:1. Cross-sectional survey was using in this research.120 cases of in-patients in the first infection ward of the Eighth Municipal people's Hospital are choosing randomly. Using AIDS TCM syndrome differentiation questionnaire and DSQL questionnaire.2. First. To investigate the AIDS TCM syndrome differentiation and to analyze the relation between the syndrome and symptoms and signs. To provide objective basis for normalized diagnostic standards. Secondly. To compare and analyze the symptoms\syndrome differentiation\pulse\tongue picture of differentPathway of infection and different age groups. Thirdly. To study the relation between TCM syndrome and characteristic immune index.3. To explore the relation between QOL and different effect factors and different AIDS TCM syndrome differentiation by using comprehensive analysis and data mining.Results.1. In this research, the median age is 38. the median is 50u/l. the median weight is 50kg. theProportion of malePatients is 61.7%middle school and technical secondary school by standard of culture is 65.0%.61.7%are jobless.78.3% are married. Spouse testPositive are 32.5%. Sexually transmission are 66.7%.2.Cardinal symptoms include:fever cough, short of breath diarrhea. Accompanied with magersucht\fatigue\insomnia\amnesia\anepithymia\dry throat and a bitter taste\depression\hyposexuality\oral ulcer. Most symptoms are of lung system and liver-Gallbladder system and bladder system. Tongue nature are red\crimson\Pale\purple. Enlarged tongue\thin tongue\purple bruises tongue\tooth-marked tongue are the major liguliform. The fur are mostly thin/curdy/greasy. The color of fur are mostly white or yellow.Pulse manifestation are mostly mutual, (for example:deep thready rapidPulse. Rolling rapid pulse. Deep thready wiry pulse. Wiry rapid pulse).3. AIDS TCM syndrome differentiation:the Proportion of wind-heat of liver channel and accumulation of dampness-poison are 30.0%. spleen and kidney deficiency with dampness are 20.8%. Qi and Phlegm stagnation with blood stasis are 20.0%. Qi and ying deficiency with weakness of lung and kidney are 15.0%. heat-poison withPyreticPhlegm in lung are 8.3%. theProportion of the five types are 94.1%. gender,Pathway of infection, magersucht and age group made a difference has done. Patients with magersucht has more sthenic syndrome whereas more deficiency-excess mixing in Patients gently magersucht. Different TCM syndrome types have different complications. Type of spleen and kidney deficiency with dampness are more likely to have diarrhea. Qi and ying deficiency with weakness of lung and kidney, heat-poison withPyreticPhlegm in lung are more likely to have wastingsyndrome. Qi and Phlegm stagnation with blood stasis are more likely to have tuberculosis.4. The Proportion of CD4<100/mm3 is 62.5%. The female patient has effect on CD4, the proportion of CD4<100/mm3 of female patient higher than male patient, whereas different pathway of infection has. Sexually and blood-supply transmission is the first Proportion of CD4<100/mm3and IDU transmission is the more proportion of CD4≥100/mm3. There are more wind-heat of liver channel and accumulation of dampness-poison and heat-poison withPyreticPhlegm in lung when CD4≥100/mm3 there are more Qi and Phlegm stagnation with blood stasis spleen and kidney deficiency with dampness Qi and ying deficiency with weakness of lung and kidney. There are more Pneumonia and wastingsyndrome in group of CD4<100mm3. There are more malignancy in group of CD4 201-350mm3. the integration of lung system and liver-gallbladder system are the effect factor in CD4201-350mm3by Logistic regression analysis between the CD4 group and age emaciation group. The OR value of lung system and liver-gallbladder system in CD4201-350mm5 group are 0.530,1.895 in CD4<100mm3 group. The effect factor is emaciation in CD4 100-200mm3. The OR value of emaciation in CD4100-200mm3 group are 170.658 times in CD4<100mm3 group. The commonPulse like deep, rapid, theady. Rolling wiry are no different in different CD4 groups. But the common tongue nature like light red. red. crimson, pale, blue and Purple makes no difference in different CD4 groups.5. Multi-linear regression analysis of QOL score and dimentionality score shows: emaciation is the only main effect factor of MOS-HIV score, body function and society function score. The skinnerPatient had lower QOL. Standard of culture and mate detect HIV masculine are the main effect factors of QOL dimentionality score. The regression coefficient of standard of culture is positive and mate detect HIV masculine is negative. So patients has higher standard of culture has better QOL. Emaciation and spouse infection are the main effect factors in health-perception dimentionality score. The skinnerPatient had lower health-perception dimentionality score. Spouse without HIV test had higher health-perception dimentionality score than HIV test negative. emaciation, standard of culture. Age are the main effect factors in role function dimentionality score. Emaciation is negative and standard of culture and age are positive, sexual contact is the main effect factors in emotion dimentionality score, sexual contact patients had better health suffering than blood supply infected patients.6. Different TCM syndrome types had different QOL.Group of Qi and ying deficiency with weakness of lung and kidney had a significant difference in QOL as compared with other four groups.Group of Qi and ying deficiency with weakness of lung and kidney had a significant difference inPhysical functioning (PF) as compared with group of spleen and kidney deficiency with dampness.Group of Qi and ying deficiency with weakness of lung and kidney had a significant difference inPain awareness(PA) as compared with group of wind-heat of liver channel and accumulation of dampness-poison.Group of Qi and ying deficiency with weakness of lung and kidney had a significant difference in cognitive functioning(CF) as compared with group of wind-heat of liver channel and accumulation of dampness-poison and group of heat-poison withPyreticPhlegm in lung. Qi andPhlegm stagnation with blood stasis had a significant difference as compared with group of spleen and kidney deficiency with dampness.Group of Qi and ying deficiency with weakness of lung and kidney had a significant difference in health dimention(HD) as compared with group of wind-heat of liver channel and accumulation of dampness-poison, and group of heat-poison withPyreticPhlegm in lung.Group of wind-heat of liver channel and accumulation of dampness-poison had a significant difference in health transition(HT) as compared with group of Qi andPhlegm stagnation with blood stasis.The score of QOL and GHP. RF. SF.. E. MH in five syndromes type groups has no significant difference after multiple comparison using Dunnett test.7. The correlation between QOL and imentionality score with symptoms integral and other systems integral by using rank correlation coefficient shows (1) TCM symptoms integral, general appearance integral. Heart and brain system integral. Lung system integral. Liver-gallbladder system integral are significantly correlated to QOL score. (2) Liver-gallbladder system integral are significantly correlated to MH. CF. E. HD score. (3) general appearance integral Heart and brain system integral. Kidney-bladder system integral are significantly correlated toPF RF SF.8. The Liver-gallbladder system integral and health suffering score of amenorrhea are significantly different to eumenorrhea in 46 patients. Whereas there are no differences in symptom types. CD4. other systems score and other QOL dimentions. The socre of Liver-gallbladder system integral in amenorrheaPatients are higher. Showing they are more depressed. Health suffering score in amenorrhea patients are lower, agitated have lower evaluation of health.Conclusions:1.AIDS patients are mostly young and middle-aged male. The infected people are normal other than drug users. The mainPathway has become sexually infection. The rate of spouse test positive are high.2. Cardinal symptoms include:fever cough, short of breath diarrhea. Accompanied with magersucht\fatigue\insomnia\amnesia\anepithymia\dry throat and a bitter taste\depression\hyposexuality\oral ulcer. Most symptoms are of lung system and liver-Gallbladder system and bladder system. Tongue nature are red\crimson\Pale\purple. Enlarged tongue\thin tongue\purple bruises tongue\tooth-marked tongue are the major liguliform. Pulse manifestation are deep thready rapidPulse. Rolling rapidPulse. Deep thready wiryPulse. Wiry rapidPulse).3. AIDS TCM syndrome type are include:wind-heat of liver channel. accumulation of dampness-poison spleen and kidney deficiency dampness. Qi andPhlegm stagnation with blood stasis. Qi and ying deficiency. weakness of lung and kidney. heat-poison withPyreticPhlegm in lung. gender., pathway of infection,magersucht and age group made a difference in differentiation. Different TCM syndrome types have different complications.4. Gender has effect on CD4 whereas different pathway of infection has. The rate of complications is different in different group of CD4. numbers. 5. Different TCM syndrome types had different QOL. The QOL and imentionality score are related to the symptoms score and other systems score. Age, sex, standard of culture, spouse infection and emaciation have important influences on QOL score. GHP.RF. and E. The QOL of amenorrhea are low.